Interpret Comparative health Systems

Introduction

            A health system is the organization of people, institutions, and the resources that deliver health care services to meet the rising health demands of certain target populations. Many varieties of the health systems exist in the world having many histories and organizational structure as there are many countries in the world. The health systems of the world have different ways of planning. In some countries, its distribution is among the market participants and in others it involves a combined effort of the government, trade unions, charities, and religious groups (Fried & Gaydos, 2012). The evaluation of the health care systems depends on various factors, but the common ones include; quality, efficiency, acceptability, and equity for all. 

A health system should have the principal goal of promoting, restoring, and maintaining health of the entire populations represented. The paper focuses on the interpretation of the comparative health systems of three countries namely Singapore, Sierra Leone, and Israel. The comparison of the health systems is not a simple task since the challenge lies in deciding what to compare. It can be the death rates, quality, efficiency, or access to health care. The Word Health Organization ranked the performance of the health Systems around the globe. The rank is not widely acceptable to all since there lacks a standard way of ranking. According to the WHO (2000) ranking, France has the best health system and others like U.S, Cuba, and Sierra Leone having the worst health systems. Navarro (2000) claims that the method of ranking, the data relied upon, and the criteria used have some criticism from scholars and other concerned agencies. In this paper, the approach used in the comparative interpretation of the health systems is a bit different. The scope of the paper focuses on the key issues of health care in respect to the diverse demographics and economic data. The comparison covers the key traditional health risks in relation to poverty, malnutrition, unsafe sex and water, among others. Another factor in use is the prevalent chronic and non-communicable risks due to reduced physical activity, overweight, diet-related factors, tobacco and alcohol related illnesses. Another aspect is the status of the issues in relation to infectious versus non-communicable diseases. In addition, the scope of the paper covers the main current public health interventions and social, cultural, political, and economic factors that affect the access to health care.

Demographic information

            According to Singapore demographics profile (2014), the estimated population is at 5.6 million. It comprises of different age groups ranging from zero to 14 years forming 13.4 percent to those above 65 years being 8.5 percent of the entire population. The age bracket of 15 to 24 years forms section of 17.8 percent and that of 25-54 years is 50.3 percent of the whole population. It forms the majority population of all the age groups. The persons between 55 to 64 years form an approximate of 10 percent of the entire population (Singapore demographics profile, 2014). The ethnic groups forming the entire Singapore population are Chinese, Malay, Indians, and others in small figures. Chinese forms 74.2 percent of the population, hence the majority. The others are Malay being 13.3 percent, Indians as 9.2 percent, and the other smaller groups being 3.3 percent of the population. The maternal mortality rates averages at three deaths in every 100, 000 live births. The average life expectancy at birth is an approximate of 84.38 years with females having a higher rate at 87.07 years than males at 81. 86 years. The infant mortality rate for both genders is at an average of 2.53 deaths per every 1000 live births. The birth rate is at 8.1 births and the death rate is at 3.42 deaths per every 1000 persons (Singapore demographics profile, 2014).

            In Sierra Leone, the total estimated population is at 5.7 million persons. The people between zeros to 14 years are approximately 41.9 percent, 15 to 24 years are 18.8 percent, and those in the 25 to 54 age brackets are 31.6 percent of the entire population. The 0 to 14 years bracket forms the majority of the population. The other age bracket of 55 to 64 years is an estimate of 3.9 percent and those above 65 years are 3.7 percent of the entire population (Sierra Leone demographics profile, 2014). Temne forms the majority of all the ethnic groups having an estimate of 35 percent of the population. Mende is 31 percent, Limba is 8 percent, Kono is 5 percent, and Kriole are 2 percent. The other ethnic groups are Mandingo and Loko as 2 percent, and the rest of the population takes up 15 percent of the population. The maternal mortality rate is 890 deaths for every 100, 000 live births whereas life expectancy at birth is 57.39 years. Females can live up to 60 years and the males up to 54.85 years. The total infant mortality rates for both genders are 73.29 deaths in every 1000 live persons. Death rates are at 11.03 deaths and birth rates at 37.4 births in every 1000 persons (Sierra Leone demographics profile, 2014).

            In Israel, the total population estimate is at 7.8 million persons. The highest population falls within the 25 to 54 years bracket forming 37.8 percent of the entire population. The population between 0 to 14 years is 27.1 percent, 15 to 24 years is 15.7 years, and 55 to 64 years is at 8.8 percent of the entire population (Israel demographics profile, 2014). The senior citizens above 65 years form 10.7 percent of the population. Israel has both Jewish and non-Jewish populations. The Jewish comprise of 75.1 percent and the non- Jewish at 24.9 percent of the total population. Some of the Jewish are Israel-born and others from Europe, America, Oceania, Africa, and Asia. The maternal mortality rate is 7 deaths in every 100, 000 live births and the life expectancy at birth is at 81.28 years. The infant mortality rate is at 3.98 deaths in every 1000 persons. The birth rate is 18.44 births and death rate is 5.54 deaths in every 1000 persons (Israel demographics profile (2014).

Economic data

            Singapore has a mixed economy and the best in business investments. The current priority economic policies were as a result of the 2010 Economic Strategic Committee report. The recommendations of the report were that Singapore should focus on productivity-driven growth by having a qualitative restructuring of the economy. It is geared towards increased value activities and becoming innovative and with highly skilled labor. Another policy is in the biomedical sciences that are a new growth of growth. Another priority policy focuses on building a vibrant and diverse corporate Ecosystem as well as becoming a smart energy economy. In addition, the country has a policy of improving land productivity and building a distinct global City. The major challenges to the economic growth of Singapore are trade barriers in the international trade, authoritarian government, and lower inflation rates than the neighboring countries. Singapore’s Gross National Product increased from 366618.40 SGD million in 2013 to 378329.70 SGD million in 2014. It averaged at 98768.38 SGD million since 1960s to 2014 (Hosseinpoor, Stewart Williams, Itani & Chatterji, 2012)

            Sierra Leone on the other hand also has priority economic policies aimed at improving the level of the economy. The country is extremely poor and half of the working population depends on food crop Agriculture. The country has significant mineral, agricultural, and fishery resources though undermined by the Civil that ended in 2000. The major recent economic priority is focusing on mining of the iron ore and oil exploration. Sierra Leone has a substantial export of rutile, diamonds, and bauxite. Thus focusing on mining is a major boost the economy. A major challenge to economic growth in Sierra Leone is Corruption. It hinders foreign investments though the country has enacted major steps towards anti-corruption campaigns. The Gross National Product in Sierra Leone was at 4.5 Billion US dollars in 2013 and its GNI per capita was worth 735.8 US dollars (Hosseinpoor, Stewart Williams, Itani & Chatterji, 2012)

            The major priority economic policies in Israel include the reforming of the governance of the large companies to reduce their market power. The move enhances the integration of the vulnerable groups into the labor market. Another priority is on improving the education standards and the promotion of welfare-to-work measures. It aims at increasing competition that in turn stimulates productivity. Another priority is on reducing government regulatory procedures and its involvement in business operations. Israel’s barrier is one of the major impediments to its economic growth. The government maintains that the barrier is important to the Jewish State’s security. Another challenge t o the economy is terrorism that claims the lives of hundreds of people. The attacks have a direct impact on the economy in various ways. The other impediment is work-force participation. A low level of workforce participation translates into smaller the national product per capita. The Gross National product in Israel was 276227.60 ILS Million in the last three months of 2014 (Central Bureau of Statistics, Israel).

Key traditional health risks

            Being part of the larger Asia continent, Singapore has the burden of preventable infectious diseases related to poverty, poor sanitation, and inadequate access to healthcare. The scenario depicts the two faces of the Asian continent. Another health risk is the disabling diseases and premature deaths. Unsafe sex leads to the emergence of STIs and HIV/ AIDS. Poor sanitation leads to diseases like diarrhea whereas under nutrition leads to malnutrition. However, according to the International standards, Singapore currently has a good state of health.

            Israel is a developed nation, but still there are some health indicators similar to those of the developing countries. Some communities experience chronic diseases like ischemic heart disease, acute myocardial infarction, cerebral vascular disease, and diabetes due to poverty. The traditional poverty-related diseases include malnutrition and diarrhea due to lack of access to good nutrition and safe water. The highly infectious diseases such as HIV/AIDS are common due to unsafe sex practices. Other health risks are premature deaths due to the unsafe sex leading to patients contracting infectious diseases that are sexually transmitted. Israel does not have a widespread use of the solid fuel that produces an indoor smoke.

            Sierra Leone is a poor country and hence it has adverse effects on the normal health of its citizens. Most of the health risks have a close relationship to the high levels of poverty, under nutrition, unsafe water, and poor sanitation. About 49 percent of the reported sicknesses and injuries are due to poor sanitation. The common illnesses due to poor sanitation include cholera and dysentery that can be fatal if not treated. Sierra Leone also has serious water shortages and unsafe water that add to the poor sanitation. Most of their water is from polluted sources like ponds and freestanding rain water. The morbidity figures show that diarrhea, worm infections, eye infections, and skin diseases accounted for 25.5 percent of all the outpatient visits to health care facilities (WHO, 2011). Another disease related to poor sanitation is malaria that accounted for 35.5 percent (WHO, 2011). Poor sanitation also leads to hepatitis A and Typhoid fever. The high incidence of diarrhea results to nutritional challenges. Unsafe sex leads to infections with the highly infectious diseases like HIV/AIDS and deaths due to unsafe abortions from unwanted pregnancies.
Prevalent chronic and non-communicable risks

            The epidemiological change in Singapore from infectious to chronic diseases creates a challenge for the public health system. The common risk factors of physical inactivity are emergence of hypertension. In Singapore, the prevalence of physical inactivity, daily smoking, unhealthy diets and regular consumption of Alcohol is the highest among men and women having least education. They all increase the risk of dying from non-communicable disease. The common among them are cardiovascular diseases, cancers, chronic respiratory problems, obesity, and diabetes. Cancer is the leading cause of death in Singapore followed by ischemic heart disease. Others are cancer, stroke, and diabetes (WHO, 2011).

            In Israel, the diet-related cancer is preventable by 60 percent due to a change in lifestyle, early diagnosis and medical interventions (WHO, 2011). The other common non-communicable diseases in Israel are heart diseases, chronic respiratory disease, and diabetes complications. Tobacco is also a threat to the health of most dwellers of Israel regardless of the smoking ban. Obesity, smoking, and heavy use of alcohol cause a risk of having cancer that result to death.

            Sierra Leone also has the problem of the non-communicable and chronic illnesses. The rates of non-communicable disease continue to increase in all countries, whether industrialized, middle or low-income earners. The country lacks financial and human resources for effectively identifying, managing, and preventing the diseases. The type of diet that many people use is of low standard, hence subjecting them to diet-related factors. The non-communicable diseases account for about 18 percent of all deaths in Sierra Leone (WHO, 2011). Most of the admissions to the only psychiatric hospital in Sierra Leone are due to drug related illnesses like tobacco, alcohol, and sedatives. The most prevalent NCDs are cardiovascular illnesses, cancers, respiratory diseases, and diabetes.

Status of the issues related to infections versus non-communicable diseases

            In Singapore, the issue of primary infectious diseases is of the past since there have been measures to combat them. The Infectious Diseases Act of 1976 helped to deal with the infectious diseases; hence currently the major problem is the non-communicable diseases (Health Promotion Board, 2012). Singapore is a developed country and issues of poor sanitation and unsafe water do not affect them. Due to lack of physical activities, obesity, change of lifestyle, tobacco and alcohol taking, non-communicable diseases become the major health risk to many people in Singapore.

            In Israel, chronic diseases like hypertension, diabetes, asthma, lung diseases, and chronic problems of the digestive system, cancer, and acute myocardial infarction are the leading causes of death. The most prevalent of them are cardiovascular diseases and cancer in Israel. Currently, Israel is not prone to many deaths from the infectious diseases. However, Leishmaniasis is an infectious disease caused by protozoan parasites that have spread across River Jordan valley to Israel, Jordan and West Bank. The improved living conditions prevent many people from contacting the infectious diseases.

            In Sierra Leone, the degree of risk to infectious diseases is very high. According to the Central Intelligence Agency, the country lacks high-quality sanitation facilities and also a safe source of clean water. The food and waterborne diseases include bacterial and protozoal diarrhea, hepatitis A, and typhoid fever. The vector-borne diseases include malaria, dengue fever, and yellow fever. Sierra Leone is worst hit by the infectious diseases in comparison to Israel and Singapore and most of them are due to poor sanitation. There are also high incidences of risks associated with the non-communicable diseases like hypertension, cardiovascular diseases, diabetes mellitus, and sickle cell disease.

Key current public health interventions

            Singapore Legislature enacted an Act to help in dealing with the infectious diseases (Health Promotion Board, 2012). Other interventions include an order of medical examination and treatment of anyone suspected to be a carrier or contact of any infectious diseases. The public health officials also have the mandate of ordering treatment or closure of premises dealing with food if suspected to be a source of transmission of an infectious disease. Another intervention is a compulsory immunization of young children against vaccine-preventable diseases in Singapore. It is an offense in failing to vaccinate children against certain diseases. However, Singapore is free from most of the vaccine-preventable diseases.

            Israel has a health promotion and preventive care delivered in various ways by the government and the Clalit health fund. The initiative provides health counseling, vaccines, child development services, and preventive examinations for the children, infants, and pregnant women. The District health officers have the responsibility of providing the public health services such as infectious disease control, food safety, and travelers’ health. Other initiatives include the health promotion and preventive medical guidelines that are updated on a regular basis. The vaccine coverage and participation are in line with many other western countries in respect to the pediatric vaccines. The distribution of influenza vaccines is free of charge by the public health officials. Clean water and sanitation are not a major problem in Israel (Elliot R., et. al., 2013).

            Sierra Leone has the poorest health indicators in the world due to the poor health systems that exist. Most of the causes of illnesses and death are preventable having most deaths arising from nutritional deficiencies, pneumonia, and malaria, TB, and HIV / AIDS. Diarrhea and respiratory diseases are also major causes of illnesses in Sierra Leone. The public health officials and other agencies work to ensure that people have access to clean water and safe sanitation (Atkinson, Vallely, Fitzgerald, Whittaker & Tanner, 2011). However, the problem is far much in effect than they can handle. Though the country is currently dealing with Ebola Virus transmission prevention, Sierra Leone is working on strengthening the public National health system in dealing with the other infectious diseases through vaccinations and provision of improved sanitation facilities.

Social-cultural, political, and economic factors affecting the access to health care

            Singapore has a stable political climate based on the rule of law. The main goal of the government is survival and prosperity. In addition, the country boasts of a competitive, corruption free, open business economic environment. It is among the best healthcare destination in Asia. Today, Singapore has a basis of the knowledge economy and attracts multinational investments. It’s social and ethnic structure is a unique mixture of cultures and people from various countries. The structures in place make Singapore have a world-class health infrastructure, technological advancements in health care industry, expert doctors, and specialists. The strategies enable the access to health care very efficient and hence people live in good health (Klomp & De Haan, 2009).

            Israel has health gaps between different social population groups. In addition, it has increasing economic inequality that enhances the disparities in health. However, the government provides quality medical care to everyone equally in a bid to close the gaps, but the initiative is not sufficient by itself (Raphael, 2013). The economic, social, and cultural factors are determinants of population health status. There exist many barriers that hinder individuals to access health services. Israel has a number of migrant workers who are not under the national health insurance. The country has gaps in health infrastructure and health status of the population due to the political barriers of closures and restrictions on freedom of movement (Hosseinpoor, Stewart Williams, Itani & Chatterji, 2012)

            Sierra Leone has experienced various military coups and attacks on multi-party democracy that affected its political stability. Corruption and nepotism entrenched into the country leading to economic problems. Unemployment and poverty are also a major contributing factor to the economic decline. Many anti-humanitarian acts were practiced especially by women including displacement from their original homes. There are several social determinants that have an impact on accessibility to health care such as poverty, health disparities, and societal inequalities. The many years of slavery to some people and the political unrests translated to poor health infrastructure and insufficient health service provision. Thus, the country lacks an efficient health care system and hence, the health of many people is at risk (Klomp & De Haan, 2009).
Conclusion

            There have been global health interventions as a way of improving the quality of life. However, some health systems still lag behind in meeting the goals of an ideal health system to all the relevant populations (WHO, 2000). There are significant differences between the well-up and the poor parts of the world. The comparative health systems study focused on various health indicators that depict the status of each health system under study. A clear distinction in the health status exists between the developed, developing, and the underdeveloped countries. Countries having a high GNP have a better health system than those with a low GNP. In addition, the demographic data shows that countries with high life expectancy have an efficient health system.

            Every nation must have a structured health system and develop it is such a way that it is in accordance with the needs and resources that it has (Lomazzi, Borisch & Laaser, 2014). The common elements in all the health systems are primary health care and public health initiatives and controls. As a country develops, the types of diseases affecting a population shift from primary infections to primary non-communicable diseases. Examples of the primary infectious diseases include diarrhea and pneumonia whereas primary non-communicable diseases include cardiovascular disease and cancers.

References

Atkinson, J., Vallely, A., Fitzgerald, L., Whittaker, M., & Tanner, M. (2011) The architecture       and effect of participation: a systematic review of community participation for     communicable disease control and elimination. Implications for malaria elimination: Malaria Journal, 10225.doi:10.1186/1475-2875-10225

Central Bureau of Statistics, Israel 

 Central Intelligence Agency (CIA) The World Fact Book; Major Infectious Diseases 

Elliot R., Itamar G., Tunie D., et. al. (2013) Healthy Israel 2020: Israel Blueprint for Health          Promotion and Disease Prevention; Public Health Reviews, Vol. 35(1)

Fried, B. J., & Gaydos, L. M. (2012) World health systems: Challenges and perspectives    (2^nded.). Chicago, Illinois: Health Administration Press.

Health Promotion Board (2012) Singapore combats Infectious Diseases with Legislation

Hosseinpoor, A. R., Stewart Williams, J. A., Itani, L., & Chatterji, S. (2012). Socioeconomic        inequality in domains of health: results from the World Health Surveys. BMC Public      Health, 12198 doi: 10.1186/1471-2458-12-198

Klomp, J., & De Haan, J. (2009) Is the political system really related to health? 

Carolyn Morgan is the author of this paper. A senior editor at MeldaResearch.Com in Write My Research Paper For Me services. If you need a similar paper you can place your order from custom nursing essay writing services.